Peer support workers (PSWs) possess personal experiences of psychiatric crises and can support individuals in their mental health recovery. The aim of this study was to examine the involvement of PSWs in acute, outreach psychiatric crisis interventions by the Crisis Intervention Service (CIS) Bremen from the perspective of the involved actors.

Collaboration between science and practice in the public health service (PHS) holds the potential to translate scientific findings into practice and to incorporate practice-oriented questions back into research. Existing collaborations can provide valuable insights into structural conditions. However, no systematic mapping has been conducted in Germany to date. The aim of this study was therefore to systematically identify and analyze science-practice collaborations within the German PHS.

The new normal following the COVID-19 pandemic is characterized by uncertainty for employees in the public health service (ÖGD), shaped by challenges such as geopolitical threats, climate change, potential future pandemics, and structural changes driven by digitalization. The present qualitative study examines work-related psychological stress factors among public health office employees during and after the COVID-19 pandemic as well as the effectiveness of measures implemented to counter these stressors.

A science-based approach in local public health services (PHS) requires robust structures both for generating practice-relevant research and for integrating this knowledge into routine public health practice. To strengthen this interface, an academia-practice research consortium developed, piloted, and evaluated the part-time trainee-rotation program "EvidenzOGD."

In Germany, hospitals undergo routine inspections (RIs) by public health authorities in an occasion-independent manner for infection prevention and control (IPC). Structure and organization of RIs is at the discretion of respective public health authorities (PHAs) and can therefore differ between districts. This work aims to provide the first representative overview of structure, organization, and content of RIs by German PHAs.

Physical activity is an important behavioural determinant of health that can be influenced by designing a physical activity-friendly environment. The aim of this work was to develop survey instruments for walkability and bikeability for the prevention reporting of the federal states.

Due to the special conditions that prevail in prisons, there are specific health risks. Drug use and poor hygiene are widespread. Typical illnesses in prisons include skin diseases, infectious diseases such as HIV and hepatitis, and nutritional deficiencies. Mental disorders, self-harm, and harm to others are also common. Medical services in prisons-known as prison medicine-therefore face particular challenges compared to regular medical care outside prisons, especially in the area of diagnosis. This concerns, among other things, the assessment of fitness for detention, the indication of specific therapies (e.g., social therapy, addiction therapy, suicide prevention), and prognostic issues, for example in connection with the relaxation of prison rules and the associated risk of abuse by the prisoner. From a medical point of view, it must also be taken into account that aggravation, that is, the deliberate exaggeration of actual symptoms, and the simulation of illness can play a certain role. The article provides an overview of the diagnostic challenges, particularly from a legal perspective.

The medical care of prisoners in the German correctional system has traditionally taken place within a parallel structure, characterized by specific actors, regulations, and conditions. In light of the serious challenges in recruiting medical personnel for correctional facilities, cooperation with the public health system is becoming increasingly important. This is evident, for example, in the growing reliance on private (specialist) physicians and in the establishment of specially secured hospital rooms for the inpatient treatment of prisoners in public hospitals.International frameworks such as the European Convention on Human Rights (ECHR), the European Prison Rules (EPR), and the Nelson Mandela Rules, as well as the reports of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), also contribute to aligning healthcare in prisons with societal standards. Nevertheless, the generally poor health status of many inmates requires special efforts to achieve a standard of care equivalent to that of the public health system.This article first provides an overview of the legal foundations of medical care in correctional facilities. It then explains in more detail the duties and responsibilities of prison physicians, describes the care structures and various medical specialties involved, and concludes by emphasizing the importance of a qualified, comprehensive assessment of deficiencies in prison healthcare.

Patient safety (PaSi) is no longer understood as merely the prevention of adverse events, but rather as all activities aimed at ensuring a safe care environment and a culture of patient safety. PaSi is considered one of the most pressing goals in healthcare. Consequently, a large number of stakeholders in joint self-administration in Germany are now working to improve PaSi. The methods used to determine PaSi range from patient surveys and voluntary reports by healthcare providers using critical incident reporting systems (CIRS) to analyses of medical records and routine data, while the search for the prerequisites for safe care makes use of classic quality management methods. Evaluation results from Germany indicate that most PaSi incidents (PSI) remain undetected and that there is still a great need for research to investigate PSI incidences, determinants of PSI, and interventions to prevent PSI as well as to create a PaSi culture.

Sexual offenses cause significant individual and societal harm. Psychosocial and psychotherapeutic interventions are considered central components of relapse prevention. However, international evidence on the effectiveness of approaches for treating individuals incarcerated for sexual offenses is inconsistent and marked by methodological limitations. This review examines the current state of research in Germany. For this purpose, the literature was systematically reviewed. The aim is to summarize the evidence on the effectiveness of treatment approaches over the past 25 years and to assess it with particular attention to methodological aspects.Empirical studies indicate that treatment can have positive effects on general recidivism (i.e., reoffending after release). However, there is no clear evidence for a reduction in sexual reoffending. Treatment dropout was associated with higher recidivism rates. Studies examining changes in risk-relevant factors report some favorable developments, but the highly heterogeneous quality and methodology of these studies limit the strength of the conclusions that can be drawn.Overall, it is currently not possible to make a definitive judgment about the effectiveness of inpatient treatment programs for sexual offenders in Germany. There is a clear need for larger, methodologically robust studies with equivalent comparison groups and detailed documentation of treatment content in order to generate reliable evidence on the effectiveness of these interventions.

Incarceration is associated with significant health burdens. Prisoners suffer disproportionately from chronic diseases, mental disorders, and substance use disorders. While primary care in prisons is usually provided regularly and sometimes even faster than outside, care for more complex treatment needs is often limited to few facilities. Structural deficits include restricted freedom of physician choice, limited specialist access, separation from the regular health system, and gaps at the transitions from incarceration to release.Despite the principle of equivalence, prison healthcare often fails to meet the standards of the statutory health insurance (in German: Krankenversicherung [GKV]). International recommendations call for the inclusion of prisoners in the GKV as well as for a transfer of healthcare responsibility from ministries of justice to ministries of health.Particularly challenging is the treatment of individuals with substance use disorders: access to evidence-based therapies is inconsistent and varies greatly from region to region. Smoking cessation and psychosocial support are also inadequate. Nutrition is also often unbalanced, while sports and physical activities are often inadequately implemented.To date, a comprehensive interdisciplinary healthcare strategy aligned with the "Healthy Prisons" approach is largely absent in Germany. The Baden-Württemberg model featuring health reporting, telemedicine approaches, age-appropriate care, and quality circles, could serve as a nationwide example. A paradigm shift is required from institution-centered care toward participatory, preventive health promotion that involves both prisoners and staff.

Since 1962, suicide cases in Hamburg's penal system have been scientifically analyzed with regard to causes and risk factors in order to improve suicide prevention measures. The present study builds on this long-term research tradition and examines suicides occurring between 2013 and 2022. Additionally, interviews with inmates and staff provide insights into the challenges of suicide prevention in custody.

Video consultations enable guideline-based and continuous medical care under the structurally challenging conditions of correctional facilities. This article presents the model of team-based telemedicine using concrete fields of application such as tele-general medicine, telepsychiatry, tele-substitution therapy, and teledermatology. Special attention is given to technical requirements, quality assurance measures, and the challenges and opportunities in correctional healthcare delivery. The approaches described are based on the experiences of the "Videoclinic" in more than 120 correctional institutions. In addition, the results of an initial empirical analysis of telemedicine routine care data (January 2023 to March 2025) and a satisfaction survey of medical and nursing staff (March 12 to 9 April 2024) are presented, which provide insights into the realities of healthcare delivery, the disease spectrum of inmates, and indications regarding the effectiveness and acceptance of telemedicine care in correctional settings.

Linking different health data at the personal level (record linkage, RL) allows answering scientific questions that could otherwise not be answered by a single data source. Linked data therefore offer great potential for health research to improve prevention, treatment, and care at the population level. Personal health data are protected by strict legal regulations. Its use requires balancing legitimate interests in protecting personal data and health benefits. However, current laws and their interpretations in Germany place severe restrictions on health data RL such that its potential for improving health outcomes is still to be leveraged. In Germany, RL is also hindered by the lack of a unique identifier that enables error-free merging across different data sources. Overall, there is a lack of interoperable solutions to perform comprehensive RL across studies and data sources in a secure environment.In this article, we propose solutions for the linkage of personal health data from different sources based on the White Paper - Verbesserung des Record Linkage für die Gesundheitsforschung in Deutschland. Our proposed solutions include, among others, the establishment of a health ID and the creation of a decentralized federated research data infrastructure with central components. Although these proposals are in line with the General Data Protection Regulation, there is a need for further legal regulation in specific cases.

The COVID-19 pandemic posed significant challenges for the public health service (ÖGD) in Germany, particularly during outbreaks in precarious living and working conditions.

German public health authorities (PHAs) bear a specific responsibility in scientific and population-based medicine, requiring specialist medical doctor and public health expertise in order to assess risks and implement measures. The data-driven verification of interventions is fundamental to their legitimacy and efficient resource allocation. This study aims to provide an overview of the international research output of German PHAs and to delineate their networks.

Studies show that the mental health of children has deteriorated since the COVID-19 pandemic and due to ongoing crises. The aim of this study is to examine the development of the prevalence of behavioral problems in recent years based on school entry data and to identify correlations and risk factors. Comparisons are made between medical and parental assessments.

Since September 2019, HIV pre-exposure prophylaxis (PrEP) has been covered by statutory health insurance (SHI) in Germany. The objectives of the PrEP-Surv study module presented here were to monitor PrEP usage from 2019 to 2022 and to examine the feasibility of using SHI claims data for an annual monitoring of PrEP provision.